ACHILLES TENDINOPATHY
The Achilles tendon is formed by the two calf muscles, Gastrocnemius and Soleus.
Achilles tendinopathy is an injury to the tendon either where the tendon meets the calf muscle, in the mid portion of the tendon or where it inserts into the heel bone. It is the mid portion tendinopathies that account for the majority.
It can cause pain, stiffness, swelling and weakness of Achilles tendon. It is more common in men than women and is more likely to develop with increasing age.
Other risk factors include reduced range of movement in the ankle, weakness in the calf muscles, especially Soleus the deeper of the two muscles, speed of running and the number of years of running and orthotic use.
The function of a tendon is to transfer the force from a muscle to bone, to act as an energy storage unit and to reduce the force applied.
There are many potential mechanisms of injury which include:
- Overloading the muscle due to sudden changes in training
- Poor mechanics of the lower leg and foot due to training on different surfaces, changes in footwear, and an imbalance in muscle activity
- Insufficient recovery where a high volume of training is followed with insufficient rest.
- Finally if the tendon has been subjected to under loading there is a possibility that there is insufficient capability the tendon to cope with acute high stress when training.
There has been vast amounts of research into the rehabilitation of Achilles tendinopathies and it is controversial as to which provides the most benefit. However it has been proven that rehabilitating both the Gastrocnemius and Soleus muscles is vital. Some individuals find heavy loaded, slow resistance training works the best while others prefer eccentric (lengthening) work for the tendon….there appears to be no right or wrong. A physiotherapist will guide you through an appropriate rehabilitation process.
Please arrange a physiotherapy assessment with one of the team here at the Wimbledon Physiotherapy Clinic if you are suffering with Achilles pain by calling 020 8542 7788 or booking online at www.wimbledonphysio.co.uk.
Source:
BJSM
Int J. Sports, Phys, Ther, 2016, Oct 11(5), 684-697
Heavy Slow Resistance versus Eccentric Training as treatment for Achilles Tendinopathy, Beyer R et al, AM J Sports Med 2015 Jul; 43(7).AM J Sports Med 2015 Jul; 43(7)
Achilles and patellar tendinopathy loading programmes, Malliaras P et al, Sports Med 2013 Apr; 43(4)